| Legacy Psychological Services, Llc | |
|
7105 Hamilton Ave Cincinnati OH 45231-5218 | |
| (513) 699-9240 | |
| (513) 681-8959 |
| Full Name | Legacy Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7105 Hamilton Ave, Cincinnati, Ohio |
| Authorized Official Name and Position | Jerome A Gabis (OWNER) |
| Authorized Official Contact | 5136999240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Psychological Services, Llc Po Box 634927 Cincinnati OH 45263-0042 Ph: (513) 891-2813 | Legacy Psychological Services, Llc 7105 Hamilton Ave Cincinnati OH 45231-5218 Ph: (513) 699-9240 |
| NPI Number | 1346267820 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 09/17/2009 |
| Medicare PECOS PAC ID | 9638196785 |
|---|---|
| Medicare Enrollment ID | O20090521000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346267820 | NPI | - | NPPES |
| 2922476 | Medicaid | OH | |
| DE6598 | Other | RR MEDICARE |
| Provider Name | Jerome Gabis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992726327 PECOS PAC ID: 6901823061 Enrollment ID: I20051028000561 |
| Provider Name | Victoria S Becker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437170867 PECOS PAC ID: 1153343850 Enrollment ID: I20051221001100 |
| Provider Name | Van Pham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184024218 PECOS PAC ID: 8820311145 Enrollment ID: I20141217002138 |
| Provider Name | Carla Frances Antenucci |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689299539 PECOS PAC ID: 6608298534 Enrollment ID: I20200623002703 |
| Provider Name | Amanpreet Randazzo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467696823 PECOS PAC ID: 6800948480 Enrollment ID: I20240417002765 |
| Provider Name | Susan Kissel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740002591 PECOS PAC ID: 8325572548 Enrollment ID: I20241111003454 |
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